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All Journal Jurnal Anestesiologi Indonesia Majalah Kedokteran Bandung
Wijaya, Wan Novriza
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Health Professions Medicine & Pharmacology Public Health

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Effects of Propofol and Thiopental on Brain Relaxation and Hemodynamic Response to Craniotomy Supratentorial Tumors Removal Valentino, Andrea; Wijaya, Wan Novriza; Anggraeni, Novita; Sony, Sony
Majalah Kedokteran Bandung Vol 57, No 4 (2025)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v57.4283

Abstract

Surgical procedures for brain tumors, particularly supratentorial tumor removal via craniotomy, present challenges related to brain relaxation and maintaining hemodynamic stability. The choice of intravenous anesthetics, such as Propofol and Thiopental, is crucial due to their distinct effects on intracranial pressure (ICP), cerebral blood flow (CBF), and hemodynamic parameters. This study aimed to compare the effects of Propofol and Thiopental on brain relaxation and hemodynamic responses during supratentorial tumor removal. A randomized experimental study was conducted at Arifin Achmad General Hospital, Riau, Indonesia, from May to September 2024 involving patients undergoing elective craniotomy for supratentorial tumors. Patients were divided into two groups: the Propofol group (1-3 mg/kg body weight, with maintenance of 50-100 µg/kg/min) and the Thiopental group (4-6 mg/kg body weight, with maintenance of 100-200 µg/kg/min), both receiving continuous infusion until a bispectral index of 40-60 was achieved. Hemodynamic parameters, including systolic blood pressure, diastolic blood pressure, mean arterial pressure (MAP), and heart rate, were measured at various stages: before induction, during surgery, and at multiple intervals. Brain relaxation was subjectively assessed by a neurosurgeon using a four-point scale. Results showed that 90% of subjects receiving Thiopental experienced good brain relaxation during duramater opening, compared to 70% in the Propofol group, though this difference was not statistically significant (p=0.118). Hemodynamically, the Thiopental group exhibited higher diastolic blood pressure and MAP at induction (p<0.05). In conclusion, Thiopental demonstrated superior hemodynamic stability, albeit both agents provided equally effective brain relaxation.
Prognostic Value of the Lactate/Albumin Ratio for Mortality in Sepsis-Associated Acute Kidney Injury: A Systematic Review and Meta-Analysis Tanjung, Fariz Fadhly; Wijaya, Wan Novriza; Anggraeni, Novita; Hidayat, Nopian; Muharrami, Vera; Irawan, Dino
JAI (Jurnal Anestesiologi Indonesia) Vol 18, No 1 (2026): JAI (Jurnal Anestesiologi Indonesia)
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jai.v0i0.76698

Abstract

Objectives: Early risk stratification in patients with sepsis-associated acute kidney injury (SA-AKI) remains challenging because conventional clinical markers have limited prognostic accuracy. The lactate/albumin ratio (LAR), reflecting metabolic stress and systemic inflammation, has emerged as a potential prognostic biomarker. This systematic review and meta-analysis aimed to evaluate the prognostic value of LAR for mortality prediction in adult patients with SA-AKI.Study design: A systematic review and meta-analysis were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Observational cohort studies reporting adjusted hazard ratios (HRs) for the association between LAR and mortality in adult patients with SA-AKI were included. Risk of bias was assessed using the Quality in Prognosis Studies (QUIPS) tool. Pooled effect estimates were calculated using a random-effects inverse-variance model.Data sources: The PubMed, Embase, and Web of Science were systematically searched from database inception to July 2025 without language restrictions. Reference lists of relevant articles were also screened to identify additional studies.Data synthesis: Eight studies were included in the systematic review, and six retrospective cohort studies involving more than 25,000 critically ill patients were eligible for meta-analysis. Elevated LAR measured during early ICU admission was independently associated with increased mortality. The pooled hazard ratio comparing the highest versus lowest LAR categories was 1.97 (95% CI: 1.42–2.73), indicating nearly a twofold higher risk of death. This association remained consistent across different populations and mortality endpoints, although substantial heterogeneity was observed (I² = 91%).Conclusions: LAR is a simple, accessible, and cost-effective biomarker for early mortality risk stratification in SA-AKI. Early measurement of LAR in ICU settings might improve the prognosis of mortality risk, thereby helping with timely decision-making.Registration: The protocol for this systematic review was prospectively registered in PROSPERO.
Co-Authors Dino Irawan Hidayat, Nopian Muharrami, Vera Novita Anggraeni Sony Sony, Sony Tanjung, Fariz Fadhly Valentino, Andrea